Pediatric Pneumonia: A Review of Clinical Practice Essentials – A Clinical Study in a Tertiary Hospital

ABSTRACT

Background: Lower respiratory tract infections are common cause of morbidity in infants and preschool children. Among them,infectious pneumonia is foremost in causing serious illness and creates problems in its diagnosis. Determination of exact etiology ofpneumonia is uncertain due to difficulty in obtaining suitable and adequate samples and shortage of accurate diagnostic methods.Aim of the Study The aim of the study was to review the clinical diagnosis, investigations, diagnosis, and management ofpneumonia in children in the light of the WHO guidelines.Materials and Methods: A total of 79 children with pneumonia attending a tertiary teaching hospital were included in thestudy. Children aged between 2 and 59 months were included in the study. Children satisfying WHO criteria for the diagnosisof pneumonia were included from the study. Children with documented evidence of comorbidities were excluded from thestudy. Demographic data, nutrition history including breastfeeding practices, immunization history, and treatment history, wereelicited. Children were divided as Group A Children with weight for age <3rd percentile, and Group B Children with weight forage ≥3rd percentile. Investigations included radiological, hematological investigations such as complete blood picture, sputumexamination, and nasopharyngeal aspirates analysis for organism and blood cultures were done. All the children were treatedfollowing the WHO guidelines. The hospital stay was grouped as <1 week group and more than 1 week group.Observations and Results: Among 79 children there were 43 (54.43%) male children and 36 (45.56%) female children. Theyoungest child was 2 months old and the eldest child was aged 57 months old with a mean age of 28.4 ± 1.3 months. Childrenbelonging to Group A were 40 (50.63%) and belonging to Group B were 39 (49.36%). Among 79 children, 46/79 (58.22%) werediagnosed as “Pneumonia” and the remaining 33/79 (41.77%) children as severe pneumonia. 62/79 (78.48%) children below36 months (3 years) were found to have either pneumonia or severe pneumonia. 17/79 (21.51%) children belonged to theage group above 36 months were found to have either pneumonia or severe pneumonia in this study. 39/62 (62.90%) childrenwho had pneumonia were below 36 months and 23/62 (37.09%) children who had severe pneumonia were below 36 months.Conclusions: Pneumonia is a clinically curable disease when identified and initiated on recommended treatment protocols.Lack of exclusive breastfeeding till 6 months of age, failure of complete immunization coverage, child malnutrition, infancy, andtoddler age are the risk factors for both types of the pneumonia but more so with severe pneumonia. There was no statisticalsignificance correlating the X-ray findings and severity of pneumonia was observed.